'Rock Doc' learns Medicare's no stairway to heaven

Miami Beach's "Rock Doc," the flamboyant Christopher Gregory Wayne, D.O., was sentenced to nearly six years in prison for Medicare fraud. The court ordered him to repay more than $1.5 million, and authorities seized his upscale Pine Tree Island home and Mercedes-Benz.

In exchange for Wayne's guilty plea, prosecutors dropped 14 healthcare fraud charges against him, according to the Miami Herald

Wayne apologized for "mistakes" at his sentencing hearing but didn't--in the words of U.S. District Judge Robert N. Scola, Jr.--"take responsibility for 90 percent of what he did." And that was robbing Medicare by claiming payment for thousands of ultrasounds, massages and electrical stimulations that were either not provided or unnecessary between 2007 and 2009.

"This was not intentional or malicious," Wayne told the court. He said he didn't know it was wrong for his unlicensed "office girls" to do physical therapy on his patients. To qualify for Medicare Part B payment, outpatient physical therapy must be done by appropriately licensed professionals.

"I only became aware of this [policy] change after my arrest," Wayne told the court. "That's why I pleaded guilty." Of Medicare's physical therapist credentialing requirement, Wayne said in a Wall Street Journal profile that "If I train them [the office staff] in physical therapy, that should be good enough."

Stephen Levine, former board member of the American Physical Therapy Association, told the WSJ that therapy Wayne claimed usually accompanies more complex treatment and is generally abusive when billed as standalone care.

"Wouldn't we all love to ... have someone rub our backs and have the government pay for it," Levine commented, "but it's just not appropriate."

Wayne's 2008 Medicare payments were more than 24 times the program earnings of the average family practitioner, the WSJ noted. He collected more than $2.6 million from Medicare between 2007 and 2009. Charges for services in his therapy regimen ranged from about $15 to $25 apiece, according to the indictment (.pdf).

Wayne later worked at a pill mill practice, where he sold painkillers and other prescription drugs to undercover law enforcement agents three times in 2011. Prosecutors said Wayne collected $428,000 for dispensing "drug cocktails" to patients without legitimate medical need.       

So the doctor with the yellow spiked hair and wardrobe of chains, bangles and leather now sports a graying ponytail and prison garb. And instead of mingling with the likes of Paris Hilton, Steven Tyler and Playboy models, Wayne now hangs with inmates.

Some say individual healthcare fraud stems from character flaws in its perpetrators. Maybe that's true. I ask myself when we'll learn that wealth gained at the expense of the healthcare system and its stakeholders is temporary and ultimately self-defeating.

And how could Wayne plead guilty but deny abusing the system? Does the need to self-justify run so deep that it prevents some of us from taking the first required step in making amends?

If character education makes a difference, then Wayne's case may be worth sharing with young people. It exemplifies what the late Carnegie Mellon professor Randy Pausch meant when he taught that it's better to be earnest than hip. It's important to be earnest about program integrity, and it's hard to be hip in prison.  

Finally, healthcare fraud has been called a contributor to the "deprofessionalization" of medicine. Will specialty societies share this message if cases like Wayne's shake public faith in doctors?       

With apologies to Led Zeppelin, it makes me wonder. - Jane (@HealthPayer)

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